anatomy and phys II Flashcards
Name the nucleui of the Hypothalamus
Lateral nucleus Ventromedial nucleus Anterior nucleus Posterior nucleus suprachiasmatic nucleus Supraoptic and paraventricular nuclei Preoptic nucleus
Lateral nucleus function
hunger
What stimulates the lateral nucleus?
Ghrelin
What does desctruction of the lateral nucleus lead to?
Anorexia, failure to thrive (infants)
Whats the function of the ventromedial nucleus ?
Satiety
What does injury to the ventromedial nucleus cause?
Hyperphagia
What stimulates the ventromedial nucleus?
leptin
anterior nucleus function
cooling, parasympethtic
posterior nucleus function
heating, sympathetic
Suprachiasmatic nucleus function
circadian rhythm
supraoptic and paraventricular nuclei function
supraoptic synthesizes ADH
paraventricular synthesizes oxytocin
Preoptic nucleus function
thermoregulation, sexual behaviour.
Releases GnRH.
What effect do prostaglandins have on the hypothalamus?
High amounts of prostaglandins will increase the anterior hypothalamus’s setpoint
The thalamus is the major relay for all ascending sensory information except what?
olfaction
What are the nuclei of the thalamus?
Ventral posterolateral Ventral posteromedial Lateral geniculate Medial geniculate Ventral lateral nucleus
What goes through the ventral posterolateral nucleus of the thalamus?
Spinothalamic and dorsal columns
What goes through the ventral posteromedial nucleus of the thalamus?
Trigeminal and gustatory pathway
What goes through the lateral geniculate nucleus?
CN II, optic chiasm, optic tract
What goes through the medial geniculate nucleus?
superior olive and inferior colliculus of tectum
What goes through the ventral lateral nucleus? (what is the input from)
cerebellum, basal ganglia
What is thalamic syndrome?
Contralateral sensory loss, usually from a lacunar stroke
Resolution may lead to long term chronic pain on contralateral side with normal sensory exam
What are the parts of the limbic system?
Hippocampus, amygdala, mamillary bodies, anterior thalamic nuclei, cingulate gyrus, entorhinal cortex
Decreased activity of the mesortical system results in….
negative symtpoms
Increased activity of the mesolimbic system results in…
positive symptoms
Decreased activity of the nigrostriatal pathway results in…
extrapyramidal symptoms
Decreased activity of the tuberoinfundibular pathway restults in…
Increased prolactin, decreased libido, sexual dysfunction, galactorrhea, gynecomastia
Output of the cerebellum?
Cerebelar cortex -> purkinje cells ->deep nuclei of cerebellum -> contralateral cortex via superior cerebellar peduncle
What information comes to the cerebellum via the middle cerebellar peduncle?
information from the contralateral cortex
What information comes to the cerebellum via the inferior cerebellar cortex?
ipsilateral proprioceptive information
Presentation of lateral lesion to cerebellum
affect voluntary movement of extremities - propensity to fall towards the injured side
Presentation of medial lesion to cerebellum
truncal ataxia (wide gait), nystagmus, head tilting. Bilateral motor deficits
Basal ganglia pathway at REST
GP internus and pars reticulata inhibit thalamus with GABA
Basal ganglia pathway to stimulate movement (direct pathway)
Cortex dumps glutamate on striatum -> activation
Striatum dumps GABA on GP internus and pars reticulata so they stop inhibiting the thalamas
The cortex also stimulates the pars compactia to further activate the striatum, using the D1 receptor
Basal ganglia pathway to inhibit movement (indirect pathway)
Cortex signals to striatum
Striatum dumps GABA onto GP externus which stops inhibiting the subthalamic nucleus
The subthalamic nucleus activates the GP internus which hholds back the thalamus to a greater degree
SIDE path:
-cortex stimulates pars compacta which inhibits the striatum via D2
Huntingtons is a problem with the …
striatum
Hemiballism is a problem with the …
subthalamic nucleus
Parkinson’s is a problem with the …
substantia nigra
Wilsions is a problem with the …
GP & Striatum
Formula for Cerebral perfusion pressure
CPP = MAP - ICP
cerebral perfusion pressure is primarily driven by…
Pco2
At what point will CPP change in response to hypoxia?
When PO2 <50 mmHg
Where are the watershed zones in the brain?
Between the anterior and middle cerebral arteries, and between the posterior and middle cerebral arteries
What does an infarct leading to decreased blood supply to the watershed areas of the brain result in?
Man in the barrel syndrome - proximal upper and lower extremity weakness
Where do the dural sinus’s empty into?
internal jugular vein
AV malformation presenation
enlarges overtime and can cause headaches/seizures
Findings in an AV malformation
Commonly results in an enlarged vein of Galen
What do the lateral ventricles drain to?
The third ventricle via the right and left intraventricular foramina of Monro
What does the 3rd ventricle drain to?
4th ventricle via cerebral aquaduct of Sulvius
Where does the 4th ventricle drain to?
Subarachnoid space via the foramina of Luschka and magendia
Which cranial nerves exit above the pons?
I, II, III, IV
Which cranial nerves exit the pons?
V, VI, VII, VIII
Which cranial nerves are in the medulla?
IX, X, XI, XII
Which cranial nerve nuclei are medial?
III, IV, VI, XII
superior colliculi function
direct eye movements to stimuli
Inferior colliculi function
auditory
Which cranial nerve’s nucleus is in the spinal cord?
XI
What travels through the optic canal?
CN II and the opthalmic artery
What travels through the superior orbital fossa?
CN III, IV, V (1) and 6
What travels through foramen rotundum?
V2
What travels through foramen ovale?
V3
What travels through the foramen spinosum?
middle meningeal artery
What travels through the internal auditory meatus?
CN VIII, CN VIII
What travels through the jugular foramen?
CN IX, X, XI, jugular vein
What travels through the hypoglossal canal?
CNXII
What travels through foramen magnum?
brain stem
spinal root of CNXI
Vertebral arteries
Red nucleus function
fine tunes movement
Treatment for trigeminal neuralgia
carbamazepine
Gag reflex affarent and efferent
IX in, X out
Muscles that close the jaw?
Masseter, medial pterygoid and temporalis
Which muscle opens the jaw?
lateral pterygoid
innervation to the muscles of mastication?
trigeminal nerve (V3)
How many spinal nerves are there in each section?
cervical- 8 (with 7 vertebrae) Thoracic - 12 Lumbar - 5 Sacral - 5 Coccyx- 1
Where does the spinal cord end in adults?
L1/L2
Where does the subarachnoid space end?
S2
Where does the spinal chord end in a child?
L2/L3
Does an epidural puncture the dura matter?
NO
How is the cortical spinal and spinothalamic tracts organized in comparison to the dorsal columns?
in the cortical spinal/spinal thalamic: legs are lateral
in the dorsal columns: arms are lateral
What is the fasiculus gracilis?
The dorsal columns that carries information from the lower body and legs
What is the fasciculus cuneatus?
The dorsal columns that carries information from the upper body and arms
Ascending dorsal columns pathway
1st order neuron enters spinal cord and ascends ipsilaterally
Synapses in the nucleus gracilis or cuneatus in the medulla with the 2nd order neuron
2nd order neuron decussates in medulla and ascends to the VPL in the thalamus
Synapses with 3rd order neuron
3rd order neuron goes to cortex
Ascending spinothalamic tract pathway
1st order neuron enters spinal cord and synapses ipsilateral in the gray matter with 2nd order neuron
2nd order neuron decussates in spinal cord as anterior white commisure and ascends contralaterlly
Synapses with 3rd order neuron in the thalamus
3rd order neuron goes to cortex
Descending path of the corticospinal tract
UMN 1st order neuron originates in motor cortex and descends ipsilaterally. Most fibers of the 1st order neuron decussate at the medulla and continue down the spinal cord.
Synapses with LMN at the level that it leaves the spinal cord.
LMN immediately leaves spinal cord and travels to neuromuscular junction.
Achilles reflex nerve roots
S1,S2
Patellar reflex nerve roots
L3,L4
Biceps reflex nerve roots
C5,C6
Triceps reflex nerve roots
C6,C7
cremasteric reflex nerve roots
L1,L2
Anal wink reflex nerve roots
S3,S4
What may cause primitive reflexes to remerge as an adult?
A frontal lobe lesion
Moro reflex
Abduct/extend arms when startled and then draw together and cry
Rooting reflex
movement of head towards one side if cheek or mouth is stroked
Sucking reflex
sucking response when roof of mouth is touched
Palmar reflex
curling of fingers if palm is stroked
Plantar reflex
dorsiflexion of large toe with plantar stimulation
Babinski sign
plantar reflex in adult - may significy UMN lesion
Galant reflex
stroking along the side of spine while newborn is in ventral suspension causes lateral flexion of lower body toward stimulated side